前列腺素E1和一氧化氮联合治疗室间隔缺损并肺动脉高压的疗效观察

目的 :观察静脉应用前列腺素E1(PGE1)、吸入一氧化氮 (NO)及二者小剂量联合应用对室间隔缺损 (VSD)并肺动脉高压的治疗作用。方法 :将 2 4例VSD并肺动脉高压的病人随机分为 3组 ,观察静脉注射PGE16 0ng/ (kg·min)、吸入NO 2 0ppm及静脉注射PGE130ng/ (kg·min)联合吸入NO 10 ppm对病人的血流动力学及血氧饱合度的影响。结果 :静脉注射PGE16 0ng/ (kg·min)使肺动脉平均压 (MPAP)明显下降 ,体动脉平均压 (MSAP)亦有所下降 ,心指数 (CI)明显增加。吸入NO 2 0 ppm组MPAP明显下降而MSAP无明显变化 ,CI有所升高 ,但差别不显著。静脉注射PGE130ng/ (kg·min)同时吸入NO 10 ppm组MPAP明显下降 ,但不显著 ,CI明显升高。 3组血氧饱合度均明显升高。结论 :联合应用小剂量PGE1和NO不仅能有效降低MPAP ,又能适当轻度降低MSAP ,改善心功能 ,减轻了NO的毒副作用 ,是一种较理想的治疗方案     

经T管窦道网篮取石治疗胆道残余结石

目的：采用非手术方法治疗胆道残余结石，方法：应用介入方法经T管窦道网蓝取石，结果：治疗39例。取得了满意的疗效。成功率达92．3％，结论：经T管窦道网蓝取石治疗胆道残余结石，是一种简便，安全、有效的治疗方法。     

鼻内窥镜下鼻中隔矫正术

目的 :研究鼻内窥镜下鼻中隔矫正术的优点。方法 :鼻内窥镜下鼻中隔矫正术 5 0例 ,同期施行传统的鼻中隔矫正术 5 0例作为对照 ,分析两者手术时间、术中出血量及疼痛情况。结果 :鼻内窥镜组治愈率为96% ,手术时间 ( 35 .5 0± 5 .2 0 ) min,术中出血量 ( 2 3.2 2± 4.2 5 ) ml,疼痛发生率为 1 6% ;传统手术组治愈率为 90 % ,手术时间 ( 4 5 .64± 6.34) min,术中出血量 ( 31 .34± 5 .64) ml,疼痛发生率为 38%。经统计学分析两组治愈率差异无显著性 ( P>0 .0 5 ) ,鼻内窥镜组手术时间明显缩短 ( P<0 .0 1 ) ,术中出血量明显减少 ( P<0 .0 5 ) ,术中疼痛发生率明显降低 ( P<0 .0 5 )。结论 :鼻内窥镜下鼻中隔矫正术照明好 ,术野清晰 ,直视下手术 ,易剥离粘连处和及时发现粘膜损伤 ,手术时间短 ,术中出血量少 ,疼痛轻 ,术后并发症少 ,特别是鼻中隔矫正同期完成功能性鼻内窥镜手术及歪鼻矫正手术时更显示其优越性     

腹腔镜下盆腔腹膜移植阴道成型术的探讨

目的 探讨腹腔镜下盆腔腹膜移植阴道成型术在妇科临床中的应用。方法使用特制的腹膜推进器行腹腔镜下盆腔腹膜移植阴道成型术。结果 术后成型的阴道上皮化良好，阴道无塌陷，性生活满意。结论 该术式损伤小、效果好、术后恢复快，是目前较理想的阴道成型方法。     

Characteristics of Bifocal Pacing:

Bifocal RIGHT ventricular stimulation (BRIGHT) is an ongoing, randomized, single-blind, crossover study of atrial synchronized bi-right ventricular (RV) pacing in patients in New York Heart Association heart failure functional class III, a left ventricular ejection fraction <35%, left bundle branch block and QRS complexes ≥120 ms. This analysis compared the electrical and handling characteristics, and the complications of pacing at the RV apex (Ap) with passive, versus RV outflow tract (OT) with active fixation leads. A mean of 1.6 ± 0.9 and 2.2 ± 2.0 attempts were needed to position the Ap and OT leads, respectively (ns). R-wave amplitudes at Ap versus OT were 23 ± 13 mV versus 14 ± 8 mV (n = 36, P < 0.001). R-wave amplitudes at the Ap remained stable between implant and M7. R-wave amplitudes at the OT could not be measured after implantation. In two patients, atrioventricular block occurred during active fixation at the OT. Conduction recovered spontaneously within 4 months. Ventricular fibrillation was induced in one patient during manipulation of an Ap lead in the RV. Marked differences were found between leads positioned in the OT versus Ap, partly related to the difference in lead design. Mean R-wave amplitude was higher at the Ap that at the OT. Ease and success rate of lead implant was similar in both positions.     

滋肾通利胶囊治疗泌尿系感染临床研究

目的：观察滋肾通利胶囊治疗泌尿系感染的临床疗效。方法：随机设对照组（120例）和治疗组（136例）,对照组根据药敏选用抗生素口服或静脉滴注,治疗组在上述基础上加用滋肾通利胶囊治疗。2周为1疗程,两个疗程后统计疗效;1年后对复发率进行比较。结果：治疗组总缓解率96.3%,对照组81.7%（P〈0.05）;1年后治疗组复发率4.4%,对照组30.0%（P〈0.01）。结论：滋肾通利胶囊对泌尿系感染有良好作用,长期疗效尤其显著。     

No Correlation Between Atrial Natriuretic Peptide Concentrations and Echocardiographic Measurements of Left Atrial Size or Left Ventricular Size and Function in Patients with Persistent Atrial Fibrillation

Atrial fibrillation (AF) may be associated with activation of atrial natriuretic peptide (ANP). The exact trigger for the release of ANP is still being debated. Atrial volume, pressure, and wall stretch are considered to be the main determinants of ANP activation. The aim of the study was to evaluate plasma ANP concentrations in patients with persistent AF and to analyze the echocardiographic determinants of ANP concentration in this group. The study population included 67 patients, 59 ± 7 years of age, with a median AF duration of 5.5 months (range 0.1–12). The relationship between plasma ANP concentrations and echocardiographic left atrial (LA) diameter and volume, and left ventricular (LV) diameter and ejection fraction (EF) was analyzed by logistic regression analysis. The median baseline plasma ANP concentration was 63 pg/mL (range 21–126) in the study group versus 34 pg/mL (range 16–73) in a control group. The mean left antero-posterior atrial dimension, LA volume, LV enddiastolic diameter, and LVEF were 48 mm, 104 mL, 52 mm, and 54%, respectively. A significant linear positive correlation was found between plasma ANP concentration and maximal LA volume (r = 0.62, P < 0.01). A negative correlation was found between LVEF and plasma ANP concentration (r =−0.42, P = 0.01). However, by multivariate regression analysis, no echocardiographic parameter was an independent predictor of plasma ANP concentration. Plasma ANP concentrations were independent of echocardiographic measurements of LA size or LV size and function in patients with persistent AF.     

左肝内胆管结石患者的64排CT数据集的三维重建和左肝切除可视化仿真手术的研究

目的 探讨64排螺旋cT的左肝内胆管结石的扫描数据,进行图像程序分割、三维重建和左肝切除术的可视化仿真手术.方法 利用64排cT扫描采集肝内胆管结石的数据集.运用医学图像处理系统(MIPS)对CT序列图像进行程序分割和三维重建,得到肝胆三维模型的数据以标准模板库STL格式输出,然后导入FreeForm Modeling System(FreeForm)利用自行开发的虚拟手术器械进行左肝切除的可视化仿真手术.结果 利用MIPS软件进行肝内胆管结石二维的CT图像程序分割速度快、效果满意.将分割的数据进行三维重建所获得的肝胆模型结构清晰、立体感强,形态逼真,可完成左肝切除的可视化仿真手术.结论 MIPS可以有效、快速地完成肝内胆管结石的64排螺旋CT的二维图像数据的程序分割、三维重建及在FreeForm进行左肝切除可视化仿真手术,为仿真的胆道外科手术提供思路.     

自拟消咳贴穴位贴敷治疗小儿反复呼吸道感染的临床研究

[目的 ]探讨自拟消咳贴穴位贴敷治疗小儿反复呼吸道感染 (RRI)的临床效果。 [方法 ]选择 15 0例RRI患儿 ,随机分为观察组和对照组 ,观察组在对因对症治疗基础上应用自拟消咳贴穴位贴敷 ,对照组采用对因对症治疗 ;另选 3 0例正常儿童 ,观察血浆内皮素 (ET -1)、一氧化氮 (NO)变化及临床疗效。 [结果 ]观察组治疗后血浆ET -1、NO含量明显下降 (P <0 .0 1) ,而对照组治疗前后则无统计学意义 ;观察组临床总有效率高于对照组 (P <0 .0 1) ,且每月发病次数及天数也明显降低。 [结论 ]应用自拟消咳贴穴位贴敷能有效地降低RRI患儿血浆ET -1、NO水平 ,从而提高临床疗效     

肩胛骨骨折的螺旋CT多平面和三维重建诊断

目的 探讨螺旋CT多平面重建（MPR）、表面遮盖显示法（SSD）及最大密度投影法（MIP）在肩胛骨骨折诊断中的价值。方法 回顾性分析40例肩胛骨骨折患者的MPR、SSD及MIP图像；所有病例均用Mareoni Ultra Z型螺旋CT机扫描，并在图像工作站上用MPR、SSD及MIP技术获得多平面和三维图像。结果 MPR、SSD及MIP重建图像清晰显示了40例共45处肩胛骨骨折及7例肩关节脱位；MPR、SSD及MIP能多方位、立体、全面地显示肩胛骨骨折部位和程度。MPR在显示微小骨折方面较好，而MIP、SSD在显示骨折的位置、形态、范围及移位方面较好。结论 MPR、SSD及MIP是诊断肩胛骨骨折的有效方法，对肩胛骨骨折分类、手术入路及内固定器选择等方案的制定有帮助。